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Manual Therapy vs. Home Exercise in Myogenic TMD With Neck Pain
Sponsor: Pamukkale University
Summary
Temporomandibular disorders (TMD) are common musculoskeletal conditions affecting the jaw joint and surrounding chewing muscles. Myogenic TMD specifically involves muscle pain and dysfunction, which is frequently accompanied by chronic neck pain due to the close anatomical and neurophysiological connections between the jaw and the cervical spine. The purpose of this study is to compare the clinical effectiveness of two widely used physiotherapy interventions-a clinician-administered manual therapy protocol and a patient-conducted home exercise program-in individuals diagnosed with myogenic TMD and chronic neck pain. The main research question is to determine whether targeted manual therapy applied to both the temporomandibular and cervical regions yields superior improvements in pain, jaw and neck mobility, quality of life, and masseter muscle properties compared to the Rocabado 6x6 home exercise program alone. 1. A total of 34 participants aged 18-45 years with myogenic TMD and chronic neck pain will be randomly allocated into two equal groups: Manual Therapy Group: Participants receive 6 individual treatment sessions (3 days per week for 2 weeks) consisting of soft tissue mobilization, trigger point therapy, myofascial release, and joint mobilization techniques applied to the jaw and neck regions. 2. Exercise Group: Participants perform the standardized Rocabado 6x6 home exercise program 3 days per week for 2 weeks, with adherence monitored through daily exercise diaries. All participants undergo comprehensive assessments at baseline and immediately following the 2-week intervention. Evaluated parameters include jaw and neck pain intensity (Visual Analog Scale), cervical and mandibular range of motion, cervical joint position sense, jaw proprioception, facial asymmetry, bruxism, TMD severity, movement-related fear (kinesiophobia), and quality of life. In addition, masseter muscle thickness and elasticity are objectively assessed using ultrasound imaging and elastography. The findings of this trial aim to provide healthcare professionals with high-level evidence regarding effective, targeted physiotherapy strategies for managing myogenic TMD co-occurring with cervical pain.
Official title: Comparative Effects of Manual Therapy Versus Home Exercise on Pain, Function, and Masseter Muscle Properties in Myogenic Temporomandibular Disorder With Neck Pain: A Randomized Controlled Trial.
Key Details
Gender
All
Age Range
18 Years - 45 Years
Study Type
INTERVENTIONAL
Enrollment
34
Start Date
2026-09-01
Completion Date
2027-02-28
Last Updated
2026-08-25
Healthy Volunteers
No
Interventions
Manual Therapy Protocol
Clinician-administered targeted manual therapy protocol applied to both the temporomandibular joint and cervical spine regions. The treatment includes soft tissue mobilization, myofascial release, trigger point therapy, and joint mobilization techniques. Administered in 6 individual treatment sessions over 2 weeks (3 sessions per week).
Rocabado 6x6 Home Exercise Program
Standardized patient-conducted Rocabado 6x6 home exercise program focusing on mandibular and cervical posture, mobility, and muscular control. Performed 3 days per week for 2 weeks. Patient adherence and compliance are tracked using daily exercise logbooks.